THE World Health Organisation (WHO) last week declared the Ebola crisis in West Africa a Public Health Emergency of International Concern.

It followed a two-day meeting which concluded that the chaotic response to the haemorrhagic disease in Guinea, Liberia and Sierra Leone, the estimated 70 per cent fatality rate and its spread to Lagos, Nigeria, signalled danger for the entire world.

Now what? Most people, including medical and scientific experts who ought to know better, imagine a vast military-style team of disease fighters will be activated, flying millions of dollars' worth of supplies, hundreds of superdoctors, cures and vaccines into the affected areas.

As in the movies Americans, Britons and French will ride to the rescue, propelled by generals from the WHO commanding a militarily precise operation, all greeted by grateful, cheering Africans.

Nothing could be further from reality. Unfortunately there is no clear framework for leadership in a globalised epidemic.

As is the case with most of the gravest threats in the 21st century (terrorism, financial collapse, climate change, resource scarcities, cyber-insecurity) epidemics that cross national boundaries must be tackled on a global scale, though the mechanisms of response are paltry. The three desperately poor countries most affected by the Ebola outbreak are now being isolated by other governments.

A de facto wall is being erected, rendering the rest of the world death-watch voyeurs. This will deepen poverty in the countries and strain relationships between sovereign nations, even leading to discriminatory policies in some regions against all Africans.

An appropriate system of governance is needed to quell these tensions and to present a united front against the virus.

Best placed politically and to some degree legally to fill the much-needed management and strategic role is WHO. It has a set of guiding principles for global health emergencies: the International Health Regulations (2005).

Without effective leadership this outbreak will spiral out of control

Yet despite being a legallybinding agreement, signed by all 194 member states, the IHR has no enforcement mechanism.

As of July 2012 only 13 countries had fully complied with these regulations and earlier this year the USA committed finances to assisting 26 additional, mostly African nations, in developing the surveillance and disease response capacities required under the regulations. These weaknesses can be overcome with tough leadership but it is WHO's sorry financial state that most limits its success.

Earlier this month the three countries most affected by Ebola collaborated with the organisation to create a plan to bring the outbreak under control.

REVEALINGLY WHO then had to plead for the £60million required to launch the plan. Fortunately the World Bank came through, pledging up to £120million in emergency funding but as the outbreak expands it is unclear where further cash will come from.

It is also unclear where the human capital will come from to fight the disease. Healthcare workers in West Africa are dying or burning out quickly and health systems are starting to collapse.

On Friday we received an email plea from Emmet Dennis, president of the University of Liberia whose medical school is handling the lion's share of care in Monrovia. His list of urgent needs is so basic as to leave us wondering what his healthcare workers actually have to work with. He needs gowns, gloves, face masks, disinfectant, body bags... the list goes on, featuring nothing more exotic or hi-tech than an infra-red thermometer.

The largest group responding to the crisis is Médecins Sans Frontières, which on Friday responded to the emergency declaration with a plaintive cry: "All of our Ebola experts are mobilised, we simply cannot do more."

If the outbreak continues to expand, Sierra Leone, Guinea and Liberia will not be able to continue their strongman role.

There is no system of well resourced, powerful governance that can take charge.

Without it the response will be ineffective and Ebola will quickly spiral further out of control.